HMO Rx

Dear Editor, Democrats and Republicans are engaged in a political test of wills to find the "right" answer to the multitude of ills created by HMO medicine. While Democrats are trying to say their Patient Bill of Rights is bigger and better than the Republican plan, the Clinton administration is asking an appeals court to overturn a tremendous victory won by Medicare HMO patients which gave them significant consumer protections and new rights. But, we must remember this is the same administration that told people over 65 they had no right to escape the functional and intentional rationing of their Medicare entitlement by choosing private medical care on a case by case basis.

The best prescription for recreating the health care free market which existed before World War II would be to return tax equity to working Americans, as economist Milton Friedman has suggested many times in the past. This would permit us to "own" our own health insurance once again. (Would anyone think it wise to change auto or homeowner's insurance every time we change jobs?) Such common sense reformation of the tax code, offering us privately owned insurance with high deductibles, would also create the same incentives and checks and balances inherent in the MSA concept. Tax equity would foster real competition by again melding the recipient of health care into the purchaser. Why would anyone oppose this sensible reform?

For years, the Association of American Physicians and Surgeons has been quite vocal about the problems created by HMOs. A few years ago, the Arizona Chapter of the AAPS led the way nationally when it played a key role in a state law which required HMOs to disclose financial incentives for their physicians (bonuses for "cost-effectiveness"), gag rules, etc. As strongly as we feel about holding accountable any physician or organization which endangers patient care, we urge caution in seeking a solution to HMO rationing through expanded government control of the HMO industry. It was government, after all, that gave us HMOs, and government which sought (and still seeks) to provide universal (rationed) health care through managed care "alliances" of HMOs under the Clinton Plan - 60 percent of which has actually been enacted by various laws since 1993! As government establishes law after law to "fix" the problem it created, it will only make medical care more costly and unwieldy. The way out of this mess is by demanding tax equity as a first --- and very necessary --- step.